Seroprevalence, seroconversion, and mother-to-child transmission of dual and triplex infections of HIV, HBV, and HCV among Nigerian obstetric population: A national multicentre prospective cohort study

Abstract

Objectives To determine seroprevalence, seroconversion, and mother-to-child transmission (MTCT) rates for dual and triplex infections of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among pregnant women. Methods A multicentre prospective cohort study was conducted in six randomly selected tertiary hospitals from six geopolitical zones of Nigeria. Consenting participants were tested at recruitment for triplex infections and followed-up till delivery. Retests were performed at delivery for those who tested negative for all three infections/positive for only one. Polymerase chain reaction was used for validation while rapid test kits were employed for initial screening. Results Of the 2775 participants recruited, 13 (0.47%; 95% CI: 0.25%–0.80%) and 4 (0.14%; 95% CI: 0.04%–0.37%) were seropositive for dual and triplex infections, respectively. Dual infections revealed seroprevalences of 0.22% for HIV-HBV (6/2775; 95% CI: 0.08%–0.47%), 0.14% for HIV-HCV (4/2775; 95% CI: 0.04%–0.37%), and 0.11% for HBV-HCV (3/2775; 95% CI: 0.02%–0.32%). Multivariable analysis highlighted significant associations between HIV/HBV co-infection and religion (adjusted odds ratio (aOR): 0.068, 95% CI: 0.006–0.757) and house ownership (aOR): 1.65 × 10 –9 , 95% CI: 1.60 × 10 –9 –1.70 × 10 −9 ). Continuing our follow-up until delivery for 2403 initial participants, 2386 did not have dual or triplex infections at the start. Upon retesting at delivery, three of these women were seropositive for a dual infection of HIV and HBV, giving a seroconversion rate of 0.12% (95% CI: 0.03% to 0.37%). MTCT rate stood at 0% at 6-week post-delivery. Conclusion We observed a relatively low seroprevalence and seroconversion rates for dual and triplex infections of HIV, HBV, and HCV among pregnant women in Nigeria and no MTCT.